When is a policy position not a just policy position? In many cases. One clear instance of this is in debates about health care reform. Preferences about health care reform and feelings about race have become intertwined.
In the just-published book that I have co-authored with Marc Hetherington, Authoritarianism and Polarization in American Politics, we argue that how Americans view political issues and establish partisan attachments is being increasingly driven by gut-level world views, which is best characterized by the term authoritarianism. Since levels of authoritarianism are powerful predictors of individuals' views on the hot button issues of the day like gay rights, immigration, and torture, they now explain whether people choose to be Republicans and Democrats, which is a key reason why our politics have become so rancorous and impervious to reasoned conciliation.
How does this dynamic relate to racial resentment and health care? While racial resentment -- which I will explain in a moment -- is not the same thing as authoritarianism, there is substantial over-lap between them. Authoritarian-minded individuals are, after all, likely to judge more negatively minority groups and those negative judgments, in turn, inform a host of political positions. And it happens that we've assembled some fascinating data from the late stages of the 2008 campaign that might shed light on the current divide over health care. Recent polls show that those who are white and over fifty are substantially less likely to support major health care reform than are other individuals. And this is certainly the face of the opposition to health care reform, as portrayed in those acrimonious town hall meetings we've become accustomed to seeing on television. But these polling data may miss a more interesting dynamic -- that there are more authoritarian-minded, racially resentful voters over fifty than under fifty, which would account for this finding.
First, here is the question from the 2008 Cooperative Campaign Analysis Project (CCAP) about health care reform:
Which comes closest to your view about providing health care in the United States?
1) The Government should provide everyone with health care and pay for it with tax dollars.
2) Companies should be required to provide health insurance for their employees and the
government should provide subsidies for those who are not working or retired.
3) Health insurance should be voluntary. Individuals should either buy insurance or obtain it
through their employers as they do currently. The elderly and the very poor should be covered by Medicare and Medicaid as they are currently.
The CCAP survey also asked people whether they agreed or disagreed(and how strongly) with four questions about racial attitudes, which, taken together, scholars call a measure of racial resentment:
1) Over the past few years, blacks have gotten less than they deserve.
2) Irish, Italians, Jewish and many other minorities overcame prejudice and worked their way up. Blacks should do the same without any special favors.
3) It's really a matter of some people not trying hard enough; if blacks would only try harder they could be just as well off as whites.
4) Generations of slavery and discrimination have created conditions that make it difficult for blacks to work their way out of the lower class.
The results are fascinating, especially when one considers that people do not generally think of health care as a racial issue. We find that in a politics organized by authoritarianism, even non-racial issues are becoming a matter of race and, more broadly, are taking on more visceral symbolic significance. Among those who identified themselves as white, the correlation between opinions about health care and racial resentment was .4. This is, it should be noted, a remarkably strong correlation for survey data.
Perhaps the most useful way to think about this data is as follows: Among those who have above average racial resentment, 19 percent favored option (1) in the health care question and more than half (57 percent) favored (3). Among those who have below average racial resentment, fully 45 percent favored option (1) and only 25 percent favored option (3). In other words, those whites who scored above the average in racial resentment were three times as likely to support the least extensive view of health care reform as those who supported significant expansion of health care coverage. Conversely, among those below the mean, respondents were about twice as likely to support significantly expanding coverage as those who supported a relatively limited view of coverage.
Why? Well scholars have demonstrated that racial animosity and opposition to policies perceived as re-distributive appear to go hand in hand. When people think of welfare, they think of Blacks. And one can surmise that, with the election of a Black president, and the rising to the surface of racial animosity among voters who, last year, were desperate enough to give Obama a chance, these relationships are even stronger now than when these data were collected last year.
In sum, there is reason to think that beneath the arguments about government intrusion into the health care market, death panels, and such, a much more visceral dynamic is at work. To be perfectly clear, it is far from the case that every opponent or skeptic of significant health-care reform is a racist or racially motivated in her or his thinking. But there is, at the least, very strong circumstantial evidence that views of race and beliefs about health care reform are linked significantly among many Americans, which probably explains why the debate on health care reform has caused a much stronger uproar in 2009 than it did in 1994.
And if that's true, as is the case with the larger worldview divide we discuss in the book, there may be no middle ground to try to reach.